Cancer of the Breast (CA Breast)

The breast is the commonest site of tumor in woman. Cancer of the breast is a leading cause of death amongst woman aged between 40-44 years. It occurs 100 times more frequently in woman than men, its incidence increase with age and is responsible for about 23% of all new cancer cases among women. More than a 1,100,000 cases occur annually worldwide, out of which about 410,000 die with same period.It occurs more in industrialized countries and tend to affect the affluent people more than the general population. It is the frequent amongst the Indians.

Influencing /Risk Factors in Breast Cancer

Age: Cancer of the breast is uncommon in women below 35years.Its incidence decrease at menopause, but increase again from 35years upwards. Development of breast cancer before 40years has three times greater risk of developing another (second) one than the general population.

Family History: Incidence is higher in those with positive family history. Positive history in a mother OR sibling give a twofold risk, while that is a mother AND sibling give a threefold greater risk than the general population.

Pregnancies (parity): A direct relationship has been reported between the risk and the age at which women had their first child. Early 1st full term pregnancies tend to have protective effect. A 1st full-term pregnancy after age of 30 years carries higher risk. Unmarried and null porous women have higher risk than married ones.

4. Age at Menopause and Menarche: Early menarche and last menopause carries higher risk. Surgical induction of menopause reduces risk while menstruating for 40years and above has higher risk than for those with an average of 30years menstruation.

Hormonal: Ovarian hormones appear to play a great part in breast cancer. Increased levels of estrogen as well as progesterone increase the risk.

9. Radiation: Increased exposure as in the case of radiation after the recent Tsunami disaster, and the Hivoshima Nagasaka bombing in Japan. Exposure of 10 RADs and above, increase the risk of cancer development.

10. Oral Contraceptive: There is association between the use of oral contraceptive and post menopausal replacement therapy, with Ca breast.

Breast Examination and Management of Ca Breast

The Tumor, Nude, and muscular involvement (TNM) staging is used for the classification of the cancer. Examination is mostly by inspection, palpation (touching), blood tests for hormone receptor/tumor markers, and by Radiological investigations (scan, mammogram, chest x-ray, MRI etc) Mammogram is not always advice for those less than 30 years of age.

Develop the attitude of regular self breast examination by inspection and touching. Know your normal relation to their sizes, shape, direction/state of the nipples, texture/ulcers on the breasts, discharges any presence of lump9(s).

Radiological investigations help us to differentiate begins from malignant (cancer) tumors, and also for their staging:

Stages 0-3: These are the early (metastases) to distant organs.

From stage 4 and above, metastases occur, and the common secondary target organs/association symptoms are:

Bones: Leading to aches, weakness.

Lungs: Cough, breathlessness, chest pain and discomfort.

Ovaries: bloated/pain, at time vaginal bleeding and discharge.

Liver/Stomach: Abdominal pain, digestion problem.

Brain: Seizures, memory loss, fainting and vision problems.

Treatment Option:

Treatment options depend on;

Age of the patient

Menopause

Previous cancer treatment

Stage of the cancer

Responsiveness of cancer to Hormone therapy. Some of the option is;

Irradiation: Use of x-rays to kill or shrink the cancer cells.

Surgical removal or debunking

Chemotherapy: Use of drugs

Hormone and antibody treatment

Note that major improvement in surgical rate has yet been by current treatment options for advanced malignant cases .Some progress rapidly even when diagnosed at an apparently early stage and others surviving for 20 years even after metastases. I all, surgical removal of the tumor at an early stage is advised; this constant self breast examination for early detection is the key.

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